전립선 비대증에서 경요도적 온열요법과 적응증

Abstract

Transurethral microwave thermotherapy (TUMT) is a new treatment modality for benign prostatic hyperplasia (BPH). From October 1992 to May 1993. among patients with BPH who are treated by TUMT (50watt. 915MHz), 40 patients who are followed up appropriately for 3 months are selected to analyze the effectiveness and indication of TUMT. Patients were divided into 4 groups according to voiding symptom and prostatic volume by transrectal ultrasonography (TRUS) : prostatism group (Group A, 27 cases) and urinary retention group (Group B, 13 cases), prostatic volume 40gm and less (Group I, 27 cases) and more than 40gm (Group II, 13 cases). We reviewed subjective symptoms of patients with Madsen & Iversen symptom score and examined urine analysis, PAP, PSA, uroflowmetry and TRUS beforeand after TUMT. The patients underwent 1 hour session on an out-patient basis with local anesthesia. The average age of patients was 70.9. Significant differences in symptom score, maximal flow rate and residual urine volume were observed in Group A and Group I compared with Group B and Group II (p<0.05). Complications were minimal, consisting of bladder spasm(7), urinary retention(4), hematuria(4) and urinary tract infection(1). We could observe the improvement of subjective symptoms and objective parameters after TUMT. Patients without urinary retention or with relatively small prostate ( <40gm) had a superiority in effectiveness. However. we failed in the cases of old age (more than 80 years old), poor in general condition and associated neurogenic bladder. Though TUMT is effective alternative treatment on patients with BPH, we considered that the selection of patient is very important to get better effectiveness. Key word : Trans Urethral Microwave Thermotherapy, Benign Prostatic Hyperplasia.